Application for Social Security Card

(Rev August 2014) Department of the Treasury Internal Revenue Service Report of Cash Payments Over $10,000 Received in a Trade or Business See instructions for definition of cash Use this form for transactions occurring after August 29, 2014 Do not use prior versions after this date

Form 8821 (Rev January 2021)

If the line 4 box is checked, skip this line If the line 4 box checked, the IRS will automatically revoke all prior tax information authorizations on file unless you check line 5

Application for Social Security Card

4 Show the month, day, and full (4 digit) year of birth; for example, “1998” for year of birth 5 If you check “Legal Alien Not Allowed to Work” or “Other,” you must provide a document from a U S

NAME : MONTREAL COGNITIVE ASSESSMENT (MOCA) Education : Date

POINTS TOTAL MEMORY NAMING VISUOSPATIAL / EXECUTIVE ATTENTION LANGUAGE ABSTRACTION DELAYED RECALL ORIENTATION Read list of words, subject must repeat them

PERSONNEL ACTION - US Army

DA FORM 4187, MAY 2014 HAS BEEN VERIFIED AUTHORITY: PRINCIPAL PURPOSE: DISCLOSURE: Title 10, USC, Section 3013, E O 9397 (SSN), as amended ROUTINE USES: The DoD Blanket Routine Uses that appear at the beginning of the Army's compilation of systems of records may apply to this system 5 GRADE OR RANK/PMOS/AOC 6 SOCIAL SECURITY NUMBER

Sales and Use Tax Blanket Exemption Certiﬁcate

es that the claim is based upon the purchaser’s proposed use of the items or services, the activity of the purchase, STEC B Rev 3/15 tax ohio gov

DEVELOPMENTAL COUNSELING FORM - US Army

DA FORM 4856, JUL 2014 Session Closing: (The leader summarizes the key points of the session and checks if the subordinate understands the plan of action The subordinate agrees/disagrees and provides remarks if appropriate ) Individual counseled: I agree disagree with the information above Signature of Individual Counseled: Date:

Post Office: Note Mail Arrival Postage Statement—Nonprofit

PS Form 3602-NZ, January 2021 (Page 1 of 2) PSN 7530-07-000-6219 This form and mailing standards are available on Postal Explorer at pe usps com United States Postal Service

[PDF] Application for Social Security Card

IRS 8300 Report of Cash Payments Over $10,000 FinCEN 8300

Form 8821 (Rev January 2021)